Why Is This Happening? The Chris Hayes Podcast Why Healthcare Costs Are Rising So Much with Jonathan Cohn
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Nov 25, 2025 
Jonathan Cohn, a senior national correspondent and healthcare expert, dives into the rising costs of U.S. healthcare. He discusses how expiring ACA subsidies have become a central issue in political debates. Cohn explains the major goals of the ACA, the impact of enhanced subsidies during the pandemic, and the political ramifications of the individual mandate debate. He also highlights how making plans more affordable has changed enrollment behavior and warns of the consequences if subsidies lapse, affecting millions of Americans.
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Why Subsidies Were Built Into Obamacare
- The ACA raised a floor for what insurance must cover and made real coverage more expensive to provide.
- Subsidies were created to offset those higher costs so non-employer buyers could afford decent plans.
Democrats' Shutdown Argument About Subsidies
- Democrats argued passionately that letting enhanced subsidies expire would cause premiums to skyrocket for exchange enrollees.
- Despite political advantages, the subsidies were not renewed and costs rose for many consumers.
COVID Subsidies Proved Affordability Works
- The ARP temporarily boosted subsidies during COVID, dramatically lowering premiums and increasing enrollment.
- That experiment showed affordability drives take-up even without a mandate.
